HomeMy WebLinkAbout5040 Deer Ridge Dr. ROWCITY OF CARMEL RIGHT-OF-WAY PERMIT
PERMIT NUMBER: b("101 -q _3
Y'S DATE: ESTIMATED DATE OF WORK:
(Person doingthe work) u
PHONE:
ADDRESS:
PHONE:
/LL
ADDRESS OF PROJECT: �3
DESCRIPTION OF WORK (cheek all that aPRIY
ROAD SORE DRIVEWAY REPLACEMENT
CONSTRUCTION ENTRANCE LANE CLOSURE [3
'BEETCUT ROAD CLOSURE E3
OTHER
DESCRIPTION: �^
TYPE OF SURFACE CUT (if applicable): ----��
*NOTE- OPEN CHIN PAVEMENT REQUIRE BOARD OF PUBLIC WORD (BPM APPROVAL`
USE OF HEAVY EQUIPMENT" YES No M )Nl 3DB -
DRAWING ATTACHED YES NO
*NOTE: ON REVERSE STE OF ITS PERMIT, PI;OVIDE NAMES AND CONTAC M OF ALLSUB-CONiRACFORS INVOLVED
ov,ru. r,ease see I;em ;Fl ortIle Right -of Way Condit'
BONDING COMPANY`. "Lj
PONDING NUMBER:
EXPIRATION DATE.
As applicant for this Right -of -J ay Permit, I understOnd and agree to all of the specifications and
conditions listed on the attached s �
'IT,
Appifcant`s 5lgaature) ( 'nt Flame)
PERMIT GRANTED BY: � 1� -- DATE ISSUED:
(City Official)
COMMENTS:
4-.,.0•7F- A� Z/
REPAIR WORK INSPECTED AND APPROVED
I have inspected the repair of the above right-of-way and find it to be completely satisfactory.
(City Inspector]
(Date Released)
I